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Patients with oral tongue squamous cell carcinoma and co‑existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment

  • Authors:
    • Amir M. Salehi
    • Lixiao Wang
    • Xiaolian Gu
    • Philip J. Coates
    • Lena Norberg Spaak
    • Nicola Sgaramella
    • Karin Nylander

  • View Affiliations

  • Published online on: February 6, 2024     https://doi.org/10.3892/ol.2024.14275
  • Article Number: 142

  • Copyright: © Salehi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Locoregional recurrences and distant metastases are major problems for patients with squamous cell carcinoma of the head and neck (SCCHN). Because SCCHN is a heterogeneous group of tumours with varying characteristics, the present study concentrated on the subgroup of squamous cell carcinoma of the oral tongue (SCCOT) to investigate the use of machine learning approaches to predict the risk of recurrence from routine clinical data available at diagnosis. The approach also identified the most important parameters that identify and classify recurrence risk. A total of 66 patients with SCCOT were included. Clinical data available at diagnosis were analysed using statistical analysis and machine learning approaches. Tumour recurrence was associated with T stage (P=0.001), radiological neck metastasis (P=0.010) and diabetes (P=0.003). A machine learning model based on the random forest algorithm and with attendant explainability was used. Whilst patients with diabetes were overrepresented in the SCCOT cohort, diabetics had lower recurrence rates (P=0.015 after adjusting for age and other clinical features) and an improved 2‑year survival (P=0.025) compared with non‑diabetics. Clinical, radiological and histological data available at diagnosis were used to establish a prognostic model for patients with SCCOT. Using machine learning to predict recurrence produced a classification model with 71.2% accuracy. Notably, one of the findings of the feature importance rankings of the model was that diabetics exhibited less recurrence and improved survival compared with non‑diabetics, even after accounting for the independent prognostic variables of tumour size and patient age at diagnosis. These data imply that the therapeutic manipulation of glucose levels used to treat diabetes may be useful for patients with SCCOT regardless of their diabetic status. Further studies are warranted to investigate the impact of diabetes in other SCCHN subtypes.
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April-2024
Volume 27 Issue 4

Print ISSN: 1792-1074
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Spandidos Publications style
Salehi AM, Wang L, Gu X, Coates PJ, Norberg Spaak L, Sgaramella N and Nylander K: Patients with oral tongue squamous cell carcinoma and co‑existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment. Oncol Lett 27: 142, 2024.
APA
Salehi, A.M., Wang, L., Gu, X., Coates, P.J., Norberg Spaak, L., Sgaramella, N., & Nylander, K. (2024). Patients with oral tongue squamous cell carcinoma and co‑existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment. Oncology Letters, 27, 142. https://doi.org/10.3892/ol.2024.14275
MLA
Salehi, A. M., Wang, L., Gu, X., Coates, P. J., Norberg Spaak, L., Sgaramella, N., Nylander, K."Patients with oral tongue squamous cell carcinoma and co‑existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment". Oncology Letters 27.4 (2024): 142.
Chicago
Salehi, A. M., Wang, L., Gu, X., Coates, P. J., Norberg Spaak, L., Sgaramella, N., Nylander, K."Patients with oral tongue squamous cell carcinoma and co‑existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment". Oncology Letters 27, no. 4 (2024): 142. https://doi.org/10.3892/ol.2024.14275